Provider Demographics
NPI:1457662504
Name:FORT NORFOLK PLAZA URGENT CARE
Entity Type:Organization
Organization Name:FORT NORFOLK PLAZA URGENT CARE
Other - Org Name:FORT NORFOLK PLAZA MEDICAL ASSOCIATES, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEWBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-333-0284
Mailing Address - Street 1:301 RIVERVIEW AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-333-0284
Mailing Address - Fax:757-743-1974
Practice Address - Street 1:301 RIVERVIEW AVE STE 502
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1065
Practice Address - Country:US
Practice Address - Phone:757-333-0284
Practice Address - Fax:757-743-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care